ReviewDiabetes care2015
Progressive renal decline: the new paradigm of diabetic nephropathy in type 1 diabetes.
Review in Diabetes care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 118 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
118 citing papers in PubMed, 2 syntheses or guidelines pooled it, 220 citations in OpenAlex.
- [Diabetic kidney disease (Update 2026) : Guidelines in a collaboration of the Austrian Diabetes Association and the Austrian Society of Nephrology].Wiener klinische Wochenschrift · 2026Guideline
- Guideline
- Changes in Albuminuria But Not GFR are Associated with Early Changes in Kidney Structure in Type 2 Diabetes.Journal of the American Society of Nephrology : JASN · 2019Trial
- Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes.PloS one · 2018Trial
- Urinary podocalyxin identifies a pre-albuminuric kidney injury window and stratifies 12-year diabetic kidney disease risk in youth with type 1 diabetes mellitus.Pediatric nephrology (Berlin, Germany) · 2026Article
- The impact of blood pressure variability and African Caribbean ethnicity on the progression of diabetic kidney disease in type 1 diabetes.Diabetologia · 2026Article
- Kidney-Targeted Nanoparticle Delivery of Formoterol Mitigates Diabetic Kidney Disease without Adverse Cardiac Effects.ACS pharmacology & translational science · 2026Article
- The Role of Complement Activation in Diabetic Nephropathy: Current Insights and Future Directions.Journal of clinical medicine · 2025Review
- Identification of the serum uric acid threshold with increasing risk for diabetic nephropathy in type 1 diabetes.Hormones (Athens, Greece) · 2025Article
- Urinary Complement proteome strongly linked to diabetic kidney disease progression.Nature communications · 2025Article
- Exploring the subtle and novel renal pathological changes in diabetic nephropathy using clustering analysis with deep learning.Scientific reports · 2025Article
- Gene Expression in Urinary Sediment Cells as an Indicator of the Contribution of Plasma Lipids to Diabetic Kidney Disease.Journal of diabetes research · 2025Article
- Influence of serum adiponectin on baseline albuminuria and subsequent decline in eGFR in African Americans: The Jackson Heart Study.PloS one · 2025Article
- Endothelial Dysfunction in the Tubule Area Accelerates the Progression of Early Diabetic Kidney Disease.Physiological research · 2024Article
- Risk factors for rapid kidney function decline in diabetes patients.Renal failure · 2024Review
- Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality.Kidney international reports · 2024Article
- Observational
- Prevalence of Chronic Kidney Disease in Type 1 Diabetes Among Adults in the U.S.Diabetes care · 2024Article
- Serum albumin and white matter hyperintensities.Translational psychiatry · 2024Article
- Integrated analysis of blood DNA methylation, genetic variants, circulating proteins, microRNAs, and kidney failure in type 1 diabetes.Science translational medicine · 2024Article
58 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
On the basis of extensive studies in Joslin Clinic patients over 25 years, we propose a new model of diabetic nephropathy in type 1 diabetes. In this model, the predominant clinical feature of both early and late stages of diabetic nephropathy is progressive renal decline, not albuminuria. Progressive renal decline (estimated glomerular filtration rate loss >3.5 mL/min/year) is a unidirectional process that develops while patients have normal renal function. It progresses at an almost steady rate until end-stage renal disease is reached, albeit at widely differing rates among individuals. Progressive renal decline precedes the onset of microalbuminuria, and as it continues, it increases the risk of proteinuria. Therefore, study groups ascertained for microalbuminuria/proteinuria are enriched for patients with renal decline (decliners). We found prevalences of decliners in 10%, 32%, and 50% of patients with normoalbuminuria, microalbuminuria, and proteinuria, respectively. Whether the initial lesion of progressive renal decline is in the glomerulus, tubule, interstitium, or vasculature is unknown. Similarly unclear are the initiating mechanism and the driver of progression. No animal model mimics progressive renal decline, so etiological studies must be conducted in humans with diabetes. Prospective studies searching for biomarkers predictive of the onset and rate of progression of renal decline have already yielded positive findings that will help to develop not only accurate methods for early diagnosis but also new therapeutic approaches. Detecting in advance which patients will have rapid, moderate, or minimal rates of progression to end-stage renal disease will be the foundation for developing personalized methods of prevention and treatment of progressive renal decline in type 1 diabetes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.